I am Syphilis patient and possible exposure to HIV

[Babu712]

Please help me out bcoz both my doctor as well as me in a great confusion after 60 days of exposure

i had a sex with a sex worker on jan 15 2008, immediately after the next day itself i have started getting symptoms like rash, Dry Cough and Nerve related issues. I consulted a Doctor he done some    complete Blood count and told me some acute infection.

on Jan 23, i consult a STD doctor bcoz of severe oral thrash,body pain, dry cough and nerve related issue.
on jan 24, i did STD related disease test and found that TPHA is positive (Syphilis)
on jan25 , my doctor told it look like secondary syphilis and started the treatment(Benzathyin Pencilin 2.4 million regimen) after 3 days of the first dose my right eye start blurring and i had problems like nerve pain back of my Eye.
on Feb 10 , i consulted a Opthamolgist he told me it look like Neuro-Syphilis (Syphilis will only shifted to Neuro-Syphilis when Coinfection HIV) . So i did a Proviral DNA Test on 12 day of exposure (Result : Negative) and that time my Lymphocyte count is high + Total WBC count also high
After completing the course of 3 regimen i faced more issues than before then my STD doctor suggested me to go for Neuro -syphilis treatment based on ophthalmologist opinion.
Drug Regimen (PRocaine Pencilin 12 lakhs per day for 21 days)

During the mean period i did 4 time Pro-viral DNA Test on 22nd day , 28 th day, 36th day and on 52 th day all the results are negative

Even i did Elisa test on 42 day and 59 day all are Negative

Then on 50 day i consulted a neurologist due to severe pain in head , neck and in spinal cord he suggest me to do MRI Brain + Spin the results are normal. But VEP done by the neurologist shows P100 progloned bilaterally and anterior visual path way lesions and when verified with  
the doctor he told me this happen during primary HIV infection but MRI shows on sign of lesions in optic nerve (they also told me MRI won't capture primary lesions in visual path way)  so i decide myself i will have HIV (bcoz during the venture of this 60 days i really suffering with syptoms like severe eye pain, headache, dry cough, body pain and nerve pain)

But from 56 the day i can able to see better (with less pain and headache) some sort of improvement.(My doctor confirmed me this can be possible only when HIV virus level come to normal after sero-conversion period) but my results on ELISA is negative on day 59

Note : on 30 ,42 ,56 and 59 th day complete blood test shows me an increase in Lymphocyte and monocyte  and Finally test results on 59th day shows more increase in monocyte but at the same time  Lymphocyte count decreases.

I am in a great confusion whether am having HIV or any other desease. Bcoz i have done the 4 proviral dna  test when my lymphocyte and WBC count are high but still results are negative and more over ELISA test on 59 th day also negative . But VEP(Neurology) test alone shows the possibility of HIV.

Is it worth to do Pro viral test after 60 days exposure or it's better to stay till 90 days ( Suggest me) (As am having syphilis along with HIV will that affect the results)

[Babu712]

Thank you so much regularjoey .. i will try to do as you said..

[Babu712]

Thanks Teak...

More over i have tested the followings and all are negative
1) Anti-Tuberclousis
2) Chlaymida
3) HSV 1 & 2
4) Herpes
5) Pneumonia

Any suspicious disease let me know so that i will do the test

[regularjoey]

I already gave you my input - HIV is not your problem.  You should forget about HIV and deal with Syphilis.  All the time and money you are spending on HIV right now should be spent on your other problems.

[Teak]

Reread my last reply to you.

[Babu712]

Thanks for your reply TEAK...

What's your gut feel percentage of chance that i may have HIV ?

If your sure i will have HIV which one made you think so..(This will really help my doctors)

Please answer the following Question

1) What is the reliability / accuracy of HIV pro-viral DNA test?
2) What is the right time to test HIV in my case apart from doing it on 90th day?
3) Do you know any person who's Pro-viral + Elisa test result is negative after 50 + days exposure and got positive after 90 th day?

Please provide your valuable inputs .....

[Teak]

You never had a risk for HIV from a handjob.

[Babu712]

regularjoey ,  hughgrant thanks to both of you for your quick reply..


1) Regarding syphilis I had it for the past 8 years... (Based on the observation that I had a chancre in my penis before 8 yrs followed by that after six months of time had a severe cough,fever for about 2 weeks)

2) Regarding the exposure it was just a Hand job the chance of getting HIV possibilities is listed as below

1) Had a small sore in the tip of my penis
2) Possibility that during late stage syphilis the small sore in the penis might be chance for transmitting HIV

All three of my doctors told me that am functionally as well as technically symptomatic to HIV. (With the observation made on this 60 days)

Note: After 56 th day only am feeling better till that point of time everyday I faced new issues in my body related to nerve vibration, headache, sore throat, body pain and even severe ear pain too.

Frankly speaking not only me my doctors are also in great confusion with following observation

Following reasons are Suspicious to HIV :

1) VEP results shows possibility of HIV primary infection
2) Shifting of syphilis to neuro syphilis level will basically happen only when person who already have secondary syphilis and had HIV exposure recently
3) All the basic symptoms are pointing to HIV alone
4) Increase in Lymphocyte and WBC count in all the four blood results taken periodically (2nd day, 10th day, 22th day, 36 day and 58 day)
5) Some sort of improvement in Eye , Nerve after 56 th day (May be a indication of sero-positive conversion )
      
Following reasons are against HIV

6) All Pro-*viral DNA test shows (Negative Results)
7) Elisa result on 59 th day is (Negative)
8) Increase in monocyte count  is against HIV pointing to other infection  (the count was initially 2 on the first day, 4 on 10th day,  12 on 22th day , 9 on 36 day and 10 on 58 day)

      





Neuro-physician Findings:

70% Chance for HIV:
1) Do Lumbar Puncture to verify whether syphilis entered into CNS system (NEURO-SYPHILIS stage)  if that is the case then it’s clearly HIV infected is what they suggesting … why bcoz neuro–syphilis never attack a person of my age it will take several years to do damage. (This above scenario is possible when person having Late syphilis co-infected with HIV) … I am going to lumbar puncture in the coming week

Note: MRI of brain and spine shows no significant lesions or abnormalities that’s why he want to do CSF VDRL for neuro-syphilis


30% Chance for CSF related viral disease:

STD Doctors Findings:

1) 75 % HIV chance based on VEP report
2) 25 % for mono-nucleues infectious disease based on monocyte increase

Ophthalmologist Findings:

1) Optic problem related to venereal disease (it might be Syphilis or HIV or Others)


Over all am totally in abuzz whether I will be alive or dead till 90 th day to know whether am infected with HIV.

My STD doctor is in thought of writing a paper regarding me after 90 th day as am very unique patient to him

Please help me is there any other way to find in this stage…your reply are highly appreciated

[Teak]

You will need to get your conclusive HIV test at 3 months post exposure. I'm sure your doctor as has advised you of it.

[hughgrant]

Your doctor has obviously suggested that you are suffering from secondary syphilis (the rash etc). This would not have come on so quickly from the exposure you have mentioned. Firstly, the incubation period before any primary symptoms for syphilis crops up is approx. 21 days. Secondary syphilis symptoms would occur some time after (variable from person to person).

However, the rash may be a coincidence and not related to the syphilis at all.

Also, if syphilis were from that exposure, the test at that point would be negative.

If it has been suggested that you have neuro-syphilis, then as Joey says, you have had it for sometime. Whether neuro-syphilis occurs with secondary syphilis or not I don't know. I have always thought neuro-syphilis was from long term infection.

You do not say whether the exposure was unprotected or not. But, symptoms starting the day after exposure are obviously not HIV related. The fact that these symptoms started so soon after exposure and progressed suggest you doc is wrong about the possibility of it being caused by HIV from this incident.

[regularjoey]

You have been overtested for HIV already - that is clearly not your problem.
Syphilis issues are discussed at another forum (my guess is - you've had it for a few years...)